Individual
MISS RENEE N WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AG-ACNP
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0816
(434) 982-0656
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
0024182220
VA
363LA2100X
Acute Care Nurse Practitioner
Primary
0024182220
VA
Other
Enumeration date
02/08/2022
Last updated
10/13/2023
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